Examining the Validity of a New Method for the Objective Assessment of Binocular Accommodative Facility (2Q-AF Test): A Comparison with ± 2.00 DS Lens Flippers.

PURPOSE: Recent technological advances have permitted to objectively record the accommodative response while shifting between two different levels of accommodation. This study is aimed at examining the concurrent validity of a new objective method for the qualitative and quantitative assessment of binocular accommodative facility, which is named 2Q-AF test, in comparison to the ±2.00 DS lens flippers. METHODS: Fifty-six individuals took part in this study (36 healthy young adults [24.4 ± 3.2 years] and 20 children [12.2 ± 0.4 years]). Participants randomly performed the 2Q-AF and the ±2.00 DS lens flipper tests. For the 2Q-AF test, a binocular open-field autorefractor was used to record the magnitude of accommodative response during a 60-sec period, while participants repeatedly changed fixation from a 5 m to a 40 cm chart when clarity of vision was achieved at each level. Due to the advantages of the proposed method, we have determined the number of cycles and the 2Q-AF score, with the latter also considering the accuracy of changes in accommodation. A standard procedure was followed for the ±2.00 DS flipper test. RESULTS: Our data exhibited a moderate association between the number of cycles with the ±2.00 DS lens flippers and the number of cycles in the 2Q-AF test in the group of young adults (p = .005, r = 0.46 [0.15-0.68]) and children (p = .007, r = 0.58 [0.19-0.81]), whereas a stronger relationship was observed when considering the number of cycles with the ±2.00 DS lens flippers and the 2Q-AF score (young adults: p < .001, r = 0.83 [0.69-0.91]; and children: p < .001, r = 0.78 [0.52-0.91]). CONCLUSIONS: The current findings show that the 2Q-AF test is a valid method for accommodative facility assessment, as suggested by its good levels of reliability and validity. This method allows to examine the accommodative facility in qualitative terms and solve most of the limitations associated with the ±2.00 DS lens flipper test.

Validation of an Objective Method for the Qualitative and Quantitative Assessment of Binocular Accommodative Facility.

Purpose: Assessing binocular accommodative facility (BAF) enables the evaluation of the interaction between the accommodative and vergence systems, which is relevant for the diagnosis of accommodative and binocular disorders. However, the tests used to assess BAF present methodological caveats (e.g., lack of objective control, vergence demands, and image size alterations), limiting its external validity. This study aimed to (i) develop a new objective method to quantitatively and qualitatively evaluate the BAF in free-viewing conditions, and explore its validity by the comparison with the Hart Chart test, and (ii) assess the inter-session reliability of the proposed method.Methods: 33 healthy young adults took part in this study. We used a binocular open-field autorefractor to continuously assess the magnitude of accommodative response during a 60-sec period, while participants repeatedly changed fixation from a far to a near chart when clarity of vision was achieved at each level. Accommodative response data were used to characterize the BAF measurement in quantitative (number of cycles) and qualitative terms (percentage of times that correctly accommodating or dis-accommodating in each level of accommodation as well as the magnitude of the accommodative change).Results: Our data revealed that the new proposed method accurately counted the number of cycles per minute when compared with the Hart Chart test (p = .23, ES = 0.02; mean difference = 0.18 ± 0.85). The inter-session reliability of the proposed method was demonstrated to be excellent (Pearson r and intraclass correlation coefficient: 0.95 to 0.98) for the parameters obtained with the BAF test.Conclusions: The present outcomes evidence that the proposed objective method allows to accurately assess the frequency and precision of BAF by the combination of the classical Hart Chart test and a binocular open-field autorefractometer. Our findings may be of relevance for the diagnosis and treatment of accommodative and binocular disorders.

When Social Networks Meet D2D Communications: A Survey.

In the last few years, one of the main characteristics of the current technological development is the constantly increasing need for data exchange among various types of devices, both mobile and fixed. Within this context, the direct communications between devices has the potential to create new, location-based peer-to-peer applications and services, as well as to help offload traffic from the congested traditional cellular networks. The main hurdles for this kind of Device to Device (D2D) communications are throughput, spectral efficiency, latency and fairness. Most of these hurdles can be overcome by the use of the new Social IoT (SIoT) paradigm, of things and people involved together in the network, guided autonomously by social relationships following the rules set by their owners. This paper aims to investigate the state of the art of socially-driven D2D communications. Upon an initial analysis, we perform an in-deep literature investigation of the main directions in which social ties can improve D2D communication, draw conclusions and identify the research topics left open.

Assessment of genomic instability and proliferation index in cultured lymphocytes of patients with Down syndrome, congenital anomalies and aplastic anaemia.

One hundred and fifteen cases [Down Syndrome (DS) n = 75, Multiple Congenital Anomalies (MCA) n = 15 and Aplastic Anaemia (AA) n = 25], with respect to their nature of predisposition to cancer, were selected for clinical, cytogenetic and cyto-molecular studies to understand the severity of genomic instability according to the nature of the different diseases. Cytogenetic studies included chromosomal aberration (CA) assays and cytokinesis block micronucleus cytome (CBMN-Cyt) assays. In DS, MCA and AA, average frequencies of nuclear anomalies (NA) were 0.015 ±â€¯0.0006, 0.021 ±â€¯0.00123, 0.031 ±â€¯0.00098, respectively and CA were 0.107 ±â€¯0.003, 0.105 ±â€¯0.008, 0.158 ±â€¯0.006, respectively per metaphase. The extent of genomic instability in patients analysed by CBMN-Cyt assays and CA assays was statistically significant in all groups. Comparatively decreased cytokinesis block proliferation index (CBPI) observed in AA patients of 1.59 ±â€¯0.05, support the assumption that decreased levels of CBPI indicate increased genomic damage. Furthermore, we performed peptide nucleic acid fluorescence in situ hybridisation (PNA FISH) analysis to understand the mechanisms behind genomic instability and telomere dysfunction. PNA FISH showed increased frequencies of telomere signal free ends (0.98 ±â€¯0.13) in individuals with higher genomic instability. Therefore, the results demonstrate that increased chromosomal instability along with higher telomere attrition or loss may initiate gross DNA damage and leads to chromosomal instability, which is an important mechanism for triggering genomic instability - an important hallmark of cancer cells.

Validation of a Low-Cost Paper-Based Screening Test for Sickle Cell Anemia.

BACKGROUND: The high childhood mortality and life-long complications associated with sickle cell anemia (SCA) in developing countries could be significantly reduced with effective prophylaxis and education if SCA is diagnosed early in life. However, conventional laboratory methods used for diagnosing SCA remain prohibitively expensive and impractical in this setting. This study describes the clinical validation of a low-cost paper-based test for SCA that can accurately identify sickle trait carriers (HbAS) and individuals with SCA (HbSS) among adults and children over 1 year of age. METHODS AND FINDINGS: In a population of healthy volunteers and SCA patients in the United States (n = 55) the test identified individuals whose blood contained any HbS (HbAS and HbSS) with 100% sensitivity and 100% specificity for both visual evaluation and automated analysis, and detected SCA (HbSS) with 93% sensitivity and 94% specificity for visual evaluation and 100% sensitivity and 97% specificity for automated analysis. In a population of post-partum women (with a previously unknown SCA status) at a primary obstetric hospital in Cabinda, Angola (n = 226) the test identified sickle cell trait carriers with 94% sensitivity and 97% specificity using visual evaluation (none of the women had SCA). Notably, our test permits instrument- and electricity-free visual diagnostics, requires minimal training to be performed, can be completed within 30 minutes, and costs about $0.07 in test-specific consumable materials. CONCLUSIONS: Our results validate the paper-based SCA test as a useful low-cost tool for screening adults and children for sickle trait and disease and demonstrate its practicality in resource-limited clinical settings.

Does scale matter? The costs of HIV-prevention interventions for commercial sex workers in India.

OBJECTIVE: To explore how the scale of a project affects both the total costs and average costs of HIV prevention in India. METHODS: Economic cost data and measures of scale (coverage and service volume indicators for number of cases of sexually transmitted infections (STIs) referred, number of STIs treated, condoms distributed and contacts made with target groups) were collected from 17 interventions run by nongovernmental organizations aimed at commercial sex workers in southern India. Nonparametric methods and regression analyses were used to look at the relationship between total costs, unit costs and scale. FINDINGS: Coverage varied from 250 to 2008 sex workers. Annual costs ranged from US$ 11 274 to US$ 52 793. The median cost per sex worker reached was US$ 19.21 (range = US$ 10.00-51.00). The scale variables explain more than 50% of the variation in unit costs for all of the unit cost measures except cost per contact. Total costs and unit costs have non-linear relationships to scale. CONCLUSION: Average costs vary with the scale of the project. Estimates of resource requirements based on a constant average cost could underestimate or overestimate total costs. The results highlight the importance of improving scale-specific cost information for planning.